Dizziness/Imbalance

This condition is treated in the General medicine clinic.

Pre-referral work-up

History

All referrals should comply to the referral standards and include in particular:

• Rapidity of onset
• Postural instability
• Associated falls/injury
• Driving status and any incidents
• Palpitations, chest pain or breathlessness - possible cardiac presyncope
• Co-morbidities and medications
• * Chest pain, palpitations and breathlessness with presyncope/syncope
• * Abnormal neurological examination
• * over 5 medications
• Examination:
  • Postural BP
  • Presence of nystagmus +/- positive hallpike manoeuvre
  • Presence of neurology - myopathy with proximal weakness, hemiplegia, hyperreflexia
  • Cardiac murmurs or signs of heart failure

Tests

• FBC
• U&ECr
• Calcium, Magnesium and Phosphate
• ECG

Interim/GP management

To refer a patient with this condition, please see the General Medicine clinic page for the full referral process and templates.

The presence of (*) could indicate a serious cardiac condition. Consider phoning the General Physician on call.

If an older patient requires input from a multidisciplinary team, we recommend referral to the Geriatrics Service based at the Repatriation Centre.

For more information please see the HealthPathways Tasmania website.

If there is an issue of cognitive function, please ask patients family/carer to attend the appointment.

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

? Sudden onset suggestive of cerebrovascular aetiology (stroke)

? Acute onset resulting in inability to self-care due to symptoms-major safety issues in home environment

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

? Chest pain palpitations

? Abnormal neurological examination

? Rapid onset and progression

We will endeavour to see these patients within two weeks.

Please contact the General Medicine Consultant on-call if you have an urgent case to be reviewed. All referrals viewed by consultant and allocated to Consultant or Unit Registrar. Registrar cases will be discussed with consultant.

Routine (Category 3)

Symptoms over years (please consider if referral is really necessary)

Availability

North

Launceston General Hospital (Level 3)
Phone: 1300 977 694
Fax: 03 6777 5227

North West

North West Regional Hospital
Phone: 6493 6300
Fax: 6464 1928

Mersey Community Hospital
Phone: 1800 636 455 
Fax: 6441 5928

South

Wellington Clinics (Level 10)
Phone: 03 6166 0000
Fax: 03 6234 3982